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Long-term Follow-up in Toxic Solitary Autonomous Thyroid Nodules Treated with Radioactive Iodine

Departments of Nuclear Medicine and Medicine and Division of Endocrinology University Hospital Nijmegen, Nijmegen, The Netherlands

Correspondence: For reprints contact: Frans Corstens, M D, Dept. of Nuclear Medicine, University Hospital Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.

ABSTRACT

The long-term effects of radioiodine treatment on thyroid function in patients with a toxic solitary autonomous thyroid nodule were evaluated. Fifty-two patients received a therapeutic dose of 20 mCi of iodine-131 (¹³¹I). Duration of follow-up was 10 ± 4 yr. Follow-up data included a biochemical evaluation of thyroid function. The failure rate (recurrent hyperthyroidism) was 2%. The incidence of hypothyroidism was 6% and was not related to the dose per gram of nodular tissue. Oral administration of 20 mCi of radioiodine is a simple and highly effective method for the treatment of patients with a toxic autonomous thyroid nodule. The risk of development of hypothyroidism is low if extranodular uptake of ¹³¹I is prevented. This can be achieved by not treating euthyroid patients, by no longer using injections of exogenous thyroid stimulating hormone in the diagnostic work-up of the patients and by always performing radioiodine imaging shortly before treatment.

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